July 2014
Newsletter

The Department of Revenue of Government of India got together drug controllers from most Indian states at the beautiful India Habitat Centre in Delhi for a day of concentrated work, along with palliative care activists and representatives of the Pharmaceutical Industry on 28 July 2014.

The Purpose: Creation of the NDPS rules to be implemented in states for implementation of the NDPS amendment.

Pallium India’s chairman and vice-chairman were there, along with Ms Tripti Tandon of Lawyers’ Collective, the president of IAPC, the editor of Indian Journal of Palliative Care and President of Cansupport.

Every line of the draft rules that Sri Rajesh Nandan Srivastava (the Director of Narcotics) had drawn up was discussed in detail and plans were made!

We are privileged to have been part of the drafting and all the process.

The real work begins now!

Pallium India is launching a “Palliative Care Information Centre” with effect from the 1st of August 2014. The primary objective of the information centre is to provide all possible information related to palliative care and about establishments where such facilities are available in India.

While all general information and material will be made available through our website www.palliumindia.org, specific information can be sought over the telephone or through email.

A manned information desk will be functioning on all days except Sundays and National holidays, from 9 am to 12 noon and can be accessed over phone (+91 9746745497) or email (info@palliumindia.org). An experienced person with medical background, trained in palliative care, will be available during this time to provide the information related to palliative care for patients, families and medical professionals.

We request all of you to utilize this facility and to spread word about this facility to all those connected to you, who you feel would benefit or might be interested in utilizing this service.

Pallium India’s Pain and Palliative Care office and Training Centre have been moved to Arumana Hospital at Vallakadavu, from Pattom. This change has been effective from July 4, 2014.

With this, the inpatient clinic, administrative office and training centre have been brought under one roof. Pallium India’s inpatient clinic has been functioning from Arumana Hospital since January 2014.

We are glad to report progress in our petition to the Kerala State Human Rights Commission. The Commission has asked the Government of Kerala to inform the steps taken by the Government to implement the policy formulated in 2008, and also whether morphine and other medicines are made available in Medical colleges and district hospitals, whether qualified doctors and nurses are appointed in these hospitals etc.

The case is to be heard on 29 August 2014.

Here is the order from the Kerala Human Rights Commission (in Malayalam); and here is the translated version.

Mr V Prabhakaran Nair lost his son, a young engineer, to cancer, eight years ago. In memory of his beloved son, Mr Prabhakaran Nair conducted an exhibition of his own paintings at Museum Auditorium in Trivandrum, from July 24 to July 28.

All profits from the event were donated to support Pallium India’s patients. The event was inaugurated by the Health Minister of Kerala, Shri V. S. Sivakumar on the 24th of July.

The National Cancer Grid is a network of major cancer centres in the country created with the mandate of:

Creating uniform standards of patient care across the length and breadth of country, bringing high quality cancer care to the doorsteps of patients.

Augmenting human resource capabilities in cancer management in the country.

Promoting collaborative research in cancer.

A 2 day summit of National Cancer Grid (NCG) is being held at Tata Memorial Cancer Hospital, Mumbai on 26, 27 July 2014. Dr Suk Dev Nayak from All India Institute of Medical Sciences, Bhubaneswar reports from the venue:

“There was a 40 min session on Palliative care just before lunch. I thought no one would be in a mood to listen to palliative care with an empty stomach and the aroma of hot lunch drifting in to the hall. Prof Maryann Muckaden and myself did three presentations in total. Prof. Maryann’s introduction was perfect. I then shared two power point presentations: the Pallium India – Human Rights Watch survey on incidence of CANCER PAIN in 4 Regional Cancer Centres, followed by the Palliative Care component and outlay under NPCDCS of Government of India. To my utter surprise, there was a lively discussion by many of the Directors. The discussion went on, and ate through the lunch time for 20 minutes. Prof Badwe had to intervene and curtail the discussion.

I hope Palliative Care slowly enters the agenda of Chief/Policy makers at RCCs and other cancer centres. Today there will be summing up and discussion on the steps forward.”

Thank you Professor Sukdev Nayak.

Project Hamrahi (meaning fellow-traveler) is a collaborative project of Australasia Palliative Link International (APLI) and Pallium India. A doctor-nurse team from Australia or New Zealand gets linked up with one of the projects catalysed by Pallium India in various parts of India, and spends a week with the local team. Most of the doctors and nurses manning palliative care teams in India have undergone six weeks or less of training with Pallium India. Hamrahi offers them much needed support with interactions to enable them to move forward to improve their services.

Please see the newsletter (pdf) from APLI to see the marvellous progress in Agartala (Tripura), Jamshedpur (Jharkhand) and in Lakshadweep. The newsletter also gives the heart-wrenching experience of Ms Usha Ravi, a palliative care clinician from Melbourne, Australia, whose mother died in a large hospital in Bangalore. She writes that the failure to accept the inevitable resulted in continuation of useless treatment which only added to her mother’s suffering. The medical system is reluctant to change, saying discussion on death is not in our culture.

In another article, Wendy Salmon talks about doctors’ refusal to accept the inevitability of death. She keeps on hearing the words, “it is not in our culture” and wonders how this can be true.

Echoing Wendy Salmon’s words, let us ask, “Really? Discussion on death is not in our culture?” On the other hand, we think Indians traditionally have accepted death as the inevitable consequence of life.

Where death does not figure is in the Indian “Medical” culture. Since the advent of modern medicine and its progress into the high-tech domain, the medical system here has steadfastly learnt to see death as the failure of treatment. Well, it is mostly in the professional’s attitude that death is seen as the enemy. But it must also be recognized that over the last half century, a large chunk of the public has also learnt to imbibe this culture of aggressive treatment to the end of life. Understandably, this causes a lot of suffering.

The “culture” has to change. Most people welcome such discussion and are grateful for it. Those who are afraid of the word death, whether they are professionals or laymen, need help. Needless to say, it would be necessary to prepare a family to receive the news when they are not ready for it.

There is really no justification for infliction of needless suffering, when someone is dying.

It was a pleasure to talk to some young people who are in the process of making a great idea work – a home that caters to children with advanced disease in Mumbai. This program that they hope to conduct in association with Zion Hospital in Mumbai will provide recreation, art, music, play and dance therapy, counselling and bereavement support. Later on, they hope to add on respite care and care at home. In the picture, you see Mansi Shah with her friend Tripti, Abhishek Tatiya (Mansi and Abhishek are the founders) and Ms Rebecca Muir of Savitri Waney Trust.

Thank you, Rebecca, for introducing these wonderful young people to Pallium India.

Best Wishes, Happy Feet Home.

True, a lot of suffering is caused by professionals being unaware of principles of pain management. But when they are indeed aware of pain management, lack of access to essential medicines stands as a huge stumbling block.

You are aware of the role that Pallium India’s WHO Collaborating Centre and many other organizations, especially the Indian Association of Palliative Care, WHO CC at Madison-Wisconsin, Human Rights Watch etc. have played in overcoming these barriers. In the article in the Lancet (383:9923, 29 March 2014), please read about the efforts that the organization ‘International Doctors for Healthy Drug Policies’ is playing in overcoming the problem.

You can also watch a short video in which Dr Khuat Thi from Vietnam, Dr Jim Cleary of WHO CC, Madison and Mr Diederik Lohman of Human Rights Watch speak about the need for a friendly policy.

Trivandrum, Kerala

The subsequent course would be in November 2014 – starting on the 3rd of November.
Contact: info@palliumindia.org, (+91)9746746530

Hyderabad, AP

At our associate centre in MNJ Institute of Oncology in Hyderabad, the next four weeks course will begin on 3 November and end on 29 November 2014. For more details on this course, visit: http://palliumindia.org/courses/hyd_ccppm/

Contact: Ms. Vineela Rapelli – Program Coordinator, mnj.palliativecare@gmail.com, (+91)91772 38901
Details on all these courses (and future courses) are available at http://palliumindia.org/courses/

For more information about any of our courses, please write to us: info@palliumindia.org or call us: (+91)471-2451366.

Pallium India’s 2-day Volunteers’ Training Program is scheduled for Aug 21 and 23, 2014. Write to info@palliumindia.org or call +91-471-2440306 to register. If you are unable to attend this training, you could register for one of the subsequent sessions on September 18 & 20 or October 23 & 25.

Disclaimer: Information provided by Pallium India has been collected from different sources and though every effort has been made to ensure that it is up-to-date, its accuracy cannot be assured. Pallium India shall have no liability for any damages, loss, injury, or liability whatsoever suffered as a result of reliance on the information provided.